By experiencing a reversal of cognitive decline, I can now identify what were, at least for me, early warning signs of dementia. I had these signs. My father before me had these signs. None of us realized that they were anything more than “aging”. Moreover, these early warning signs, or early changes, came on so gradually that I never realized what was happening to me. I just couldn’t see it clearly. Dementia is very insidious that way. It comes on slowly, and by the time the signs are significant, the mind is often too weary to recognize them.

Starting around the age of 40, and over the next 8 years, I developed a progressive difficulty recognizing faces, and was frequently confused about whether or not I had met people before. I rationalized that I just had a quirky mental weakness. I also started to experience a growing mental “fatigue”, especially after 3 or 4 pm. I (mistakenly) thought I was just very “tired”. Helping my kids with homework felt exhausting. In addition, I began to feel sometimes “fuzzy” when I was in meetings, having little to add to discussions, particularly meetings held at the end of the day. All of this was upsetting to me because I had always prided myself in being a fairly sharp and analytical thinker. But that clarity was slowly, subtly, ebbing away.

As I got into my mid/late-40’s, I noticed that I was losing my interest in reading (although I’d been an avid reader all my life), in part because I often had trouble remembering what I had read, and in part because some material seemed too complex. Complicated movies felt hard to follow. I could no longer write or edit with ease and clarity. What I didn’t realize then, but now see in hindsight, was that my vocabulary had shrunk considerably, my typing speed had slowed markedly, and my driving had become anxiety-provoking and uncomfortable.

I also started to search for words, and sometimes even used wrong words entirely, such as: calling out to the toll booth operator “conference call” instead of “carpool”, for example; or calling for my dog in the back yard using the word “chili”, what I was cooking for dinner, instead of her name. My kids and I laughed when I did things like that, but inside, I was scared.

I also started missing, or almost missing, appointments – something I had rarely, if ever, done before. I rationalized that I was just a very busy person. But as a result, I became increasingly anxious about keeping track of my schedule, relying ever more on various calendars and alarms to keep me on top of things. During these years, I developed difficulty sleeping, and was frustrated that coffee no longer seemed to help me to become alert in the mornings.

Also during my mid/late 40’s, I began to have trouble remembering what I needed to do in a day. When my kids needed something, I would ask them to write down their requests on a big piece of paper in my kitchen. If they didn’t use that paper, it didn’t get done. I told them it was just so hard to remember things because there was “too much going on.”

To others, it seemed like I was carrying on “normally”. To me, though, it felt otherwise. Life felt overwhelming. I felt I was aging so fast. And by the age of 48, I privately knew that professionally, I was – at best- in decline, and -at worst – finished. I just wasn’t telling anyone.

Two years ago, I contacted the Dementia Prevention Center at Weill-Cornell in New York City because I wanted to “prevent” following in my father’s footsteps. The prevention center put me through a battery of cognitive tests (approximately 3 hours long), which felt – to my surprise – very difficult. I scored average or below average on most of the tests, well below what was expected but not so badly to sound any alarms. They also did some blood work on me, and it was from that that I learned that I was Apoe4 positive (I am E2/E4) [Editor’s Note: Apoe4 is colloquially known as the “Alzheimer’s Gene.”] They told me about the cognitive benefits of the MIND diet and exercise, and asked that I come back in 6 months.

Learning I was ApoE4 terrified me. I wasn’t sure where to turn, but I wanted help. That was when a family member sent me Dr. Bredesen’s paper “Reversing Alzheimer’s”, and from there everything changed. I started to follow Dr. Bredesen’s protocol, which includes:

1. Exercise: 5-6 days per week for 30-60 minutes each day (if 30 minutes, then must be vigorous)
2. Sleep 7-8 Hours (ideally 8), using melatonin and L-Tryptophan if night awakening.
3. Fast (autophagy): 13-15 hours per day (between dinner and breakfast), including at least 2-3 hours before bed.
4. Diet: I am following the MIND diet (which is similar to Dr. Bredesen’s version of the diet):

• No processed foods
• Nothing “white”: white flour, white sugars etc. (simple carbohydrates)…just whole grains
• Leafy grains daily
• Other vegetables daily
• Berries (esp. blueberries)
• Coffee daily (but stay consistent with the amount)
• Nuts and seeds daily
• Coconut oil/MCT oil daily (I put it in my coffee)
• Olive oil daily
• Avocados regularly
• 1 glass of wine per day, red or white
• Dark chocolate is ok
• Limited red meat
• Fish/poultry is ok – fish at least once per week
• Limit/eliminate fast foods, pastries, sweets, cheese, butter and cream

5. Personalized supplements (based on his general recommendations and my own blood work)

6. Stress reduction: meditation, socializing, minimizing stress as much as possible

7. Intellectual engagement/learning etc. (e.g., I am re-learning a language, writing etc.)

I had absolutely no expectation of experiencing improvements, because I had not yet connected the dots about my cognitive changes. As a result, when the changes came (which they did with a vengeance), I was completely taken by surprise.

Fast forward three months. July. In the middle of an exercise class one day, I looked around and suddenly realized that I actually recognized some people. Even more, I knew that I knew them. I had never had that feeling in that class before. In fact, I usually felt embarrassed to say hello to others because I was never certain that I knew them.

Fast forward another two months. September. I attended “Parent’s Day” at my kids’ school. That day was typically anxiety-provoking for me because I wasn’t sure who people were or whether I should know them (unless they put on a name tag). This time, though, I actually had fun. I not only recognized people, but I knew that I knew them and enjoyed going up to people and engaging in conversation.

Fast forward another month. October. My True Awakening. Over a period of 4-6 weeks, other changes came on, one after another. Literally from one day to the next, it felt like I was waking up further, like a fog was peeling off my brain. I began to feel mentally much sharper. I became much more alert in meetings and in conversations. My reading comprehension and recollection greatly improved. I suddenly really wanted to read again; I wanted to learn. Then one day I noticed that I was using words I hadn’t used in years. I hadn’t been missing those words, because I didn’t notice their departure. But when those out-of-circulation vocabulary terms re-emerged, I felt joyous. It was like seeing long-lost friends again after years of separation.

Also during that time, my “4pm fatigue” dissipated. Prior to that, I had dreaded the time from 4-10 pm when my kids needed me most, but when my mind was just too tired. Suddenly (and truly it felt sudden) I was mentally alert up until bedtime. Homework help? No problem! Late night run to the supermarket? Sure! I realized then that the “4pm fatigue” had come on so slowly, so insidiously, that I hadn’t recognized it for what it was: the creeping in of dementia.

My memory started to improve then, too. I no longer needed my kids to leave me those reminder notes on big pieces of paper in the kitchen. I kept track of my schedule again, often in my head. Likewise, I felt more in control and confident when driving. A calm set in. I began to enjoy lengthy, complex conversations, and complicated movies. I even noticed that when I drank coffee in the mornings, I actually felt the caffeine effect again.

One day around that time, I sat down to write something and noticed two things. One, I could type really fast. I hadn’t realized I had slowed down so much, but suddenly my fingers were flying across the keyboard. And two, I found that I actually could write. I had ideas. And they were flowing.

That was when I knew I was back.

Shortly thereafter, in early December, I repeated the three-hour battery of cognitive tests. Many of my scores had jumped from average or below average to the top percentiles. The neurologist who administered the tests told me that, given the dramatic improvement, he could say that while previously I’d been in early cognitive decline, I had definitely fully resolved.

Since that time, I have continued on Dr. Bredesen’s protocol. I have also continued to experience other improvements in my cognitive functioning. For example, several foreign languages I’d learned as a child started to come back to me, sometimes in waves of words. I also can read sheet music again. I had tried to read music and play the piano shortly after starting the protocol, but discovered I could no longer read the notes. Two years later, though, I sat down at a piano again, and to my shock – and great joy! – I could read all of the notes, and play with the same ease as when I was young.

On reflection, I can now see that what I, and my father before me, faced mid-life were very clear, early warning signs of dementia: increasing facial “blindness”; “4pm fatigue”; anxiety about schedules and appointments (and sometimes missing them); gradual loss of interest in reading, movies, complex conversations; gradual decreasing clarity and thinking speed; gradual decrease in vocabulary; intermittent word search problems; slip-ups with language; anxiety about driving; difficulty remembering “to do’s”, loss of foreign language and musical skills, and sleep disruption. There was a pattern there. I just hadn’t seen it.

In my case, I know I got lucky, very, very lucky. I happened upon a prevention center thanks to my mother. They convinced me to get genetic testing, despite my strong reservations. And then, in the name of prevention, I started Dr. Bredesen’s protocol. Little did I know that what I really needed was treatment.

I also know I am lucky because my beautiful husband has been completely supporting me. He cheers me on. He exercises with me. And he helps me stay the course with my diet, my fast, and with my sleep, none of which are always easy. I am grateful to him every single day.

And finally, I feel lucky because now I appreciate what it means to think clearly unlike I ever did. It’s so awesome! And it is so, so wonderful to be here, and to be able to be really truly present with my children, my husband, my family and friends. Really, when I think about it, what’s better than that?”  -DKF